Breast augmentation is the most common form of plastic surgery in the United States.

The rate of breast augmentation surgery in the U.S. rose a whopping 64% between 2000 and 2007, and as of a 2011 report, it’s the most common kind of plastic surgery in the nation. The reported 307,180 breast implant procedures last year did include cases of gender reassignment surgery and reconstruction after a mastectomy. The majority, however, were neither. Most participants in a JustBreastImplants.com forum thread about motivation report that they had breasts and wanted bigger ones- not to satisfy the demands of anyone else, but out of a wholly personal desire.

What’s Behind A Desire For Larger Breasts

Florence Williams’s cool new book Breasts: A Natural and Unnatural History calls human preoccupation with large breasts a contested issue among scientists. Most evolutionary biologists believe breasts developed in female bodies to send attractive signals to potential male mates about age and fertility—basically, the bigger, the better. Others challenge this theory because it relies on the flawed hypothesis that early human female survival relied on male hunting aid and protection. After all, this school argues, larger breasts do not actually signify a human organism that is more fertile or more able to breastfeed.

The controversy over why some people like big breasts cannot be settled in this blog post. It is worth noting that breasts aren’t prioritized or fetishized to the same extent in every society, indicating that culture plays a big role in large-breast preference. While it’s impossible to determine the exact blend of genetic, sociological and individual factors leading people to get breast implants, it’s important to consider the way the procedure affects different women’s bodies, health, and lives.

The Afterlife of Breast Implants

According to WebMD, the process of breast augmentation costs around $5000 to $10,000 and is rarely covered by insurance. It’s an outpatient surgery, and most patients experience some breast pain during recovery. Breast implants affect different people in different ways, so here are some things to consider:

Breastfeeding: Most people can lactate and breastfeed after breast augmentation. However, the surgery makes an “inadequate milk supply” three times more likely, so some nursing mothers with implants use supplementary feeding methods.

Side effects and risks: Williams notes that breast augmentation almost always results in some decline in breast sensation. She goes on to say that concern over a correlation between implants and breast cancer hasn’t held up, though implants can make mammograms harder to read. The bigger issue is that a lot of research isn’t ready yet. An ongoing study seems to imply a high risk of long-term symptoms like fatigue and joint pain, but the end results won’t be released for years.

Reoperation: “Cosmetic failure,” or botched augmentation, is not all that uncommon, and between 15 and 29% of patients repeat surgery within three years. No breast implants last forever, and the FDA recommends consistent follow-up appointments even for those patients who are satisfied with their implants.

Judged Over Jugs: The Confusing Role of Breast Implants in American Society

Every day, Americans take steps to modify and control their appearance through style decisions, nutritional patterns, gender expression and, sometimes, plastic surgery. For a lot of people, self-presentation is deeply tied to a sense of individual choice. At the same time, decisions about one’s appearance are always influenced, consciously or not, by societal forces and interpersonal histories.

Social critics have contested the notion that America’s most common plastic surgery rose to popularity solely because millions of straight women wanted larger breasts “just for themselves.” A particularly controversial essay even compared the role of breast implants in American society to female genital cutting in other parts of the world. While both of the above links lead to thought-provoking arguments, people considering cosmetic breast implants should keep in mind that breast augmentation is one procedure in a whole diverse world of body modification. If you’re looking into breast implants, the most important things to consider are your safety, your health and your future satisfaction.